unlocking dyslexia ida 2007. the picture of dyslexia ann w alexander, m.d. the morris center...
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UNLOCKING DYSLEXIA
IDA 2007
THE PICTURE OF DYSLEXIA
ANN W ALEXANDER, M.D.THE MORRIS CENTER
GAINESVILLE, FLwww.TheMorrisCenter.com
TIM CONWAY, Ph.D.UNIVERSITY OF FLORIDA
GAINESVILLE, FL
IDA 2007
THE PICTURE OF DYSLEXIA
WHAT
WHY
WHAT IT LOOKS LIKE
WHERE WHEN
WHAT TO DO
WHOTHE
&
WHAT IT ISN’T DYSLEXIA IS …
NOT A VISUAL PROBLEM
NOT A LACK OF INTELLIGENCE
NOT DUE TO LACK OF EFFORT
NOT RESPONSIVE TO STANDARD READING
INSTRUCTION
NOT UNCOMMON – 5 – 17.5 %
OF POPULATION
NOT A DEVELOPMENTAL LAG.A DEVELOPMENTAL LAG.
WHAT IT ISDYS = TROUBLELEXIA = WORDS
TROUBLE WITH WORDS
NEUROLOGIC IN ORIGIN - GENETIC
LIFELONG – ENVIRONMENT MAY ALTER COURSE
CORE DEFICIT IN PHONOLOGICAL COMPONENT OF LANGUAGE
READING COMPREHENSION > WORD READING
ACCOMPANYING CHALLENGES ( 50% )
ADHD
SENSORY MOTOR DIFFICULTY
BEHAVIORAL PROBLEMS
MORE CHALLENGING TO REMEDIATE
THE PICTURE OF DYSLEXIA(All Symptoms Do Not Occur With Everyone)
STRENGTHS
LEADERSHIP SKILLS THINKING “OUT OF THE BOX”
JFK
PA
TT
ON
CHURCHILL
POLITICAL &
MILITARY
TED TURNER
THOMAS EDISON
(PHONOGRAPH)
ENTREPRENEURS SCIENTISTS&
INVENTORS
HANS CHRISTIAN
ANDERSENLEONARDO
Da VINCIHARRISON FORD &STEVEN SPEILBERG
THE PICTURE OF DYSLEXIA(All Symptoms Do Not Occur With Everyone)
STRENGTHS
CREATIVITY
WRITERS ARTISTS MUSICIANS ACTORS / DIRECTORS
MOZART
THE PICTURE OF DYSLEXIA(All Symptoms Do Not Occur With Everyone)
STRENGTHS
VISUOSPATIAL / MOTOR SKILLS
SURGEONS ATHLETES
NEUROSURGERY MOHAMMAD ALI NOLAN RYAN
COMPENSATE
PROMOTE
ACCOMMODATE
REMEDIATE
WHAT TO DO?
WHAT TO REMEDIATE?
“IF YOU DON’T KNOW THE CAUSE YOU GET INSTRUCTIONAL PARADIGMS BUILT
ON FAULTY ASSUMPTIONS.” G. Reid Lyon, Ph.D.
PHONOLOGICAL AWARENESS
THE CORE DEFICIT
WHAT IS PHONOLOGICAL AWARENESS?
PHONOLOGICAL AWARENESS
THE UNDERSTANDING THAT WORDS ARE MADE UP OFTHE UNDERSTANDING THAT WORDS ARE MADE UP OF
SMALL BITS OF SOUND – SMALL BITS OF SOUND – PHONOLOGICAL SENSITIVITYPHONOLOGICAL SENSITIVITY
INNATE IN A TYPICAL BRAIN RECEIVINGINNATE IN A TYPICAL BRAIN RECEIVING APPROPRIATE LANGUAGE APPROPRIATE LANGUAGE INPUTINPUT
Do the words Do the words catcat and and fatfat sound the same at the end? sound the same at the end?
What is the first sound in the word What is the first sound in the word manman??
Torgesen, www.fcrr.org
THE ABILITY TO IDENTIFY, THINK ABOUT, THE ABILITY TO IDENTIFY, THINK ABOUT, ANDAND
MANIPULATE THE INDIVIDUAL SOUNDSMANIPULATE THE INDIVIDUAL SOUNDS
(PHONEMES) IN WORDS(PHONEMES) IN WORDS
THE IMPLICATION OF A THE IMPLICATION OF A GROWINGGROWING ABILITY ABILITY TO TO
IDENTIFY INDIVIDUAL SOUNDS IN IDENTIFY INDIVIDUAL SOUNDS IN WORDS.WORDS.
PHONEMIC AWARENESSPHONEMIC AWARENESS
Torgesen, www.fcrr.org
EARLY LANGUAGE DEVELOPMENT
BRAIN IS TUNED TO PARENTS’ LANGUAGE
NEWBORN: INTEGRATES:
ORAL-FACIAL MOVEMENTSSPEECH SOUNDS – PHONOLOGYSOCIAL – EMOTIONAL (NON VERBAL TONES & GESTURES) - PRAGMATICS
LANGUAGE(BUILDING BLOCKS)
18 MONTHS ___
1 MONTH ___
9 MONTHS ___
5 YEARS ___
9 YEARS ___
PHONOLOGY(FORM)
PRAGMATICS(FUNCTION)
SEMANTICS
(MEANING)
SYNTAX
(FORM)
READING
WRITINGSPELLING
METALINGUISTIC
PRINCIPLES OF LEARNING
WHAT FIRES TOGETHER, WIRES TOGETHER – MULTIPLE SENSES STRENGTHEN PATHWAYS
OPTIMAL ATTENTION
CONSISTENT INPUT
INTENSITYSALIENTFREQUENT REPETITION, REPETITION, REPETITION
Alexander, 2003
PHONOLOGY
EXECUTIVE FUNCTION / INTENTION
WORKING MEMORYHOLD / MANIPULATE
(PERCEPTION / PRODUCTION)
ATTENTION / AROUSAL
ACOUSTIC
STIMULUS
VISUAL
STIMULUS
MOTOR ARTICULATORY
STIMULUS
SOMATOSENSORY ARTICULATORY
STIMULUS
PHONEMIC REPRESENTATION
PROSODICREPRESENTATION
(WORD LEVEL)
READING
EXECUTIVE FUNCTION / INTENTION
WORKING MEMORY
HOLD / MANIPULATE
ATTENTION / AROUSAL
(PERCEPTION / PRODUCTION)
PHONICS RULES
SYNTACTIC REPRESENTATION
SEMANTIC / LEXICALREPRESENTATION
ARTICULATORY
REPRESENTATION
PHONOLOGIC
REPREESENTATION
ORTHOGRAPHIC
REPRESENTATION
MORPHOSYNTACTIC
REPRESENTATION
PROSODIC
REPRESENTATION
DYSLEXIC
THE EFFECTS OF WEAKNESSES IN ORAL LANGUAGE ON READING GROWTH
(Hirsch, 1996)
5 6 7 8 9 10 11 12 13 14 15 16
16
15
14
13
12
11
10
9
8
7
6
5
Read
ing
Ag
e
Level
Chronological Age
Low Oral Language in Kindergarten
High Oral Language in Kindergarten
5.2 years difference
Torgesen, www.fcrr.org
EARLY READING DEVELOPMENT
BREAKING THE CODE
DECODING(MECHANICS)
LANGUAGECOMPREHENSION
READING COMPREHENSION+
RECIPE FOR READING
WHAT IS “PHONICS”?WHAT IS “PHONICS”?
IT MUST BE IT MUST BE TAUGHTTAUGHT
NEED NEED PAPA ( (SOUNDSSOUNDS) TO HOOK TO ) TO HOOK TO ABSTRACT WRITTEN SYMBOLS ABSTRACT WRITTEN SYMBOLS ((LETTERSLETTERS))
IT’S A LEARNED IT’S A LEARNED SKILLSKILL
PRONOUNCE THESE PRONOUNCE THESE WORDS…WORDS…
blitblit frachetfrachet
GROWTH IN “PHONICS” ABILITY OF CHILDREN WHO BEGIN FIRST GRADE IN THE BOTTOM 20% IN PHONEME AWARENESS AND LETTER KNOWLEDGE (Torgesen & Mathes, 2000)
6
2
4
1 2 3 4 5
1
3
5
5.9
2.3
Low PA
K
Ave. PA
GRADE LEVEL CORRESPONDING TO AGE
RE
AD
ING
GR
AD
E L
EV
EL
AverageLow
`Torgesen, www.fcrr.org
GROWTH IN WORD READING ABILITY OF CHILDREN WHO BEGIN FIRST GRADE IN THE BOTTOM 20% IN PHONEME AWARENESS AND LETTER KNOWLEDGE (Torgesen & Mathes, 2000)
6Low PA
5.7
3.5
2
4
1
3
5
K
Ave. PA
GRADE LEVEL CORRESPONDING TO AGE
1 2 3 4 5
RE
AD
ING
GR
AD
E L
EV
EL Average
Low
Torgesen, www.fcrr.org
GROWTH IN READING COMPREHENSION OF CHILDREN WHO BEGIN FIRST GRADE IN THE BOTTOM 20% IN PHONEME AWARENESS AND LETTER KNOWLEDGE (Torgesen & Mathes, 2000)
1 2 3 4 5
Low PA
3.4
2
4
6
1
3
5
K Ave. PA
6.9
GRADE LEVEL CORRESPONDING TO AGE
RE
AD
ING
GR
AD
E L
EV
EL
Average
SAME VERBAL ABILITY – VERY DIFFERENT READING COMPREHENSION
Low
Torgesen, www.fcrr.org
AUDITORY /
SOUNDING OUT
VISUAL /
SIGHT WORDS
LANGUAGE /
VOCABULARY
GRAMMAR
COMPREHENSION
FLUENCY
3 – LEGGEDSTOOL
NORMAL READER
AUDITORY /
SOUNDING OUT
VISUAL /
SIGHT WORDS
LANGUAGE /
VOCABULARY
GRAMMAR
COMPREHENSION
FLUENCY
3 – LEGGEDSTOOL
AUDITORY /
SOUNDING OUT
AUDITORY /
SOUNDING OUT
AUDITORY /
SOUNDING OUT
AUDITORY /
SOUNDING OUT
AUDITORY /
SOUNDING OUT
AUDITORY /
SOUNDING OUT
DYSLEXIA
WHERE
“SIGNATURE” BRAIN IMAGES ARE THE SAME
DIFFERENT LANGUAGES AFFECT THE PICTURE ITALIAN VS ENGLISH
ANYWHERE
WHO
ANYONE
ALL AGES
ALL WALKS OF LIFE
PREPONDERANCE IN :ARCHITECTSENGINEERSSURGEONSENTREPRENEURSSCHOOL DROPOUTSPRISON INMATES
WHEN
AS EARLY AS THE NEWBORN PERIOD
IDENTIFICATION OF A PHONOLOGIC “GLITCH”
THE WEAKER THE PHONOLOGY, THE EARLIER THE STRUGGLE
THE PICTURE OF DYSLEXIA
WHAT DOES IT “LOOK” LIKE?
THE PICTURE OF DYSLEXIA(ALL SYMPTOMS DO NOT OCCUR WITH EVERYONE)
ORAL LANGUAGECHALLENGES
LISTENING
Memory for word sequence
(phone numbers, directions)
Poor PHONOLOGICAL
AWARENESS
ForeignLanguage
SPEAKING
Word Finding
Multi-syllables
SequencingIdeas
ForeignLanguage
THE PICTURE OF DYSLEXIA
WRITTEN LANGUAGECHALLENGES
(ALL SYMPTOMS DO NOT OCCUR WITH EVERYONE)
READING
Mechanics Comprehension
SpeedMechanics
Speed
SPELLING/WRITING
ExpressingIdeas
THE PICTURE OF DYSLEXIA(ALL SYMPTOMS DO NOT OCCUR WITH EVERYONE)
ACCOMPANYING CHALLENGES(SENSORIMOTOR)
Oral MotorMessy Eating
Writing/knots Fingers
Eyes
Tired
Words Swim
LosePlace
Spatial Awareness
Up/Down
Left/Right
THE PICTURE OF DYSLEXIA(ALL SYMPTOMS DO NOT OCCUR WITH EVERYONE)
ACCOMPANYING CHALLENGES(BEHAVIORAL)
Parents with similarchallenges
Brain / BehaviorDisorders
Attention /Executive Function
Anxiety
Depression
OCD
OppositionalBehavior
DEVELOPMENTAL DIFFERENCES
PRESCHOOL:
SENSORIMOTOR ORAL LANGUAGE ATTENTION
EARLY ELEMENTARY:
PRINT RECOGNITION
LETTER – SOUND KNOWLEDGE
MECHANICS OF READING
HANDWRITING
ATTENTION
DEVELOPMENTAL DIFFERENCES
HIGH SCHOOL / ADULT: READING EFFICIENCY
COMPREHENSION
FOREIGN LANGUAGE
ATTENTION
MID ELEMENTARY / MIDDLE SCHOOL: COMPREHENSION
WRITTEN EXPRESSION
ATTENTION
WHAT TO DO
ASSESSMENT OF STRENGTHS AND WEAKNESSES
NEUROCOGNITIVE
PSYCHOSOCIAL
ASSESSMENT DRIVES TREATMENT
BELL SHAPED CURVENORMAL POPULATION DISTRIBUTION
PROFILE GRAPHBRAIN TEAM
SEVERE AT RISK AVERAGE SUPERIOR GIFTED
WEAKNESS RANGE STRENGTH
Standard Scores 65 70 75 80 85 90 95 100 105 110 115 120 125 130 135
Percentiles 1st 2nd 5th 9th 16th 25th 37th 50th 63rd 75th 84th 91st 95th 98th 99th
ATTENTION/ INTENTION
Visual
Auditory
INTELLIGENCE/COGNITION
Fluid Reasoning
Executive Processes
Processing Speed
ORAL LANGUAGE
Phonological Awareness
(Morpho)Syntactic Awareness
Receptive (Listening)
Expressive (Speaking)
Word Retrieval (Naming)
MEMORY
Aud. Working Memory
Vis. Working Memory
SENSORIMOTOR
Visual Processing
Visuo/Motor Ability
PROFILE GRAPHBRAIN TEAM RESULTS
SEVERE AT RISK AVERAGE SUPERIOR GIFTED
WEAKNESS RANGE STRENGTH
Standard Scores 65 70 75 80 85 90 95 100 105 110 115 120 125 130 135
Percentiles 1st 2nd 5th 9th 16th 25th 37th 50th 63rd 75th 84th 91st 95th 98th 99th
WRITTEN LANGUAGE
Word Reading (Real)
Word Reading (Rate)
Word Reading (Nonsense)
Word Reading (Rate)
Passage Comprehension
Passage Fluency
Writing/Written Expression
Writing Fluency
Spelling
ARITHMETIC
Concepts
Operations
Applications
Fluency
PRESCHOOL PREDICTORS OF
FUTURE READING SUCCESS
PHONOLOGICAL AWARENESS
LETTER NAME KNOWLEDGE
RAPID NAMING of OBJECTS, COLORS
ALL OF THESE PREDICTORS ARE DEPENDENT ON A STRONG PHONOLOGICAL SYSTEM
NOT IQ !!! Torgesen, www.fcrr.org
TREATMENT
EARLY IDENTIFICATION
PREVENTION OF READING DIFFICULTIES
LATER IDENTIFICATION
INTERVENTION FOR READING DIFFICULTIES
PREVENTION STUDY MID KG – END 2ND GRADE
SCREENING - BOTTOM 10TH %ILE
FREQUENCY – 20 MINUTES / 4 DAYS / WEEK
INTENSITY – 1:1, 67 HRS.
TEACHERS & AIDES
4 METHODS – PASP (MULTISENSORY, “BOTTOM UP”- LiPS)EP (TRADITIONAL RDG INSTRUCTION WITH EXPLICIT PHONICS)
RCS (SUPPORT OF CLASSROOM TEACHING)
NTC (NO TREATMENT CONTROL) Torgesen et al, 1999
NICHD
PREVENTION STUDY OUTCOME
ONLY PASP YIELDED SIGNIFICANT PHONOLOGICAL
AWARENESS AND WORD READING GAINS
END OF 2ND GRADE: 50TH %ILE WORD READING SKILLS
(ACCURACY AND FLUENCY).
OTHERS NO BETTER THAN NO TREATMENT CONTROL
BEST PREDICTORS OF GROWTH IN READING:
ATTENTION/BEHAVIOR, HOME BACKGROUND, AND P/A.
A SOLUTION TO THE PROBLEM OF THE FLUENCY GAP: PREVENTIVE INTERVENTIONS
10th 10th
70
80
90
100S
TA
ND
AR
D S
CO
RE
Accuracy
Rate
4th
GRADE
2nd
GRADE
30th % ile
BEGINNING % ile
TREATMENT AGE 5-6 5-6
Torgesen et al, 2003
WORD READING
DYSLEXIA PREVENTION STUDY“BOTTOM-UP” VS “TOP-DOWN”
PASP (LiPS) USES A MORE EXPLICIT, CONCRETE, MULTISENSORY (“BOTTOM UP”) APPROACH TO DEVELOP PHONOLOGICAL AWARENESS
NTC
RCS
EP
LiPS
0
5
10
15
20
25
30
35
40
45Percentretainedin K or 1
Torgesen et al, 1999
30th
70th 75th
50th
25th
OCTOBER JANUARY MAY
NA
TIO
NA
L
PER
CEN
TIL
E
GROWTH IN WORD READING ABILITY
Torgesen, www.fcrr.org
KINDERGARTEN
FIRST GRADE
Left Right
AT RISK READER
BEFORE BEFORE INTERVENTIONINTERVENTION
AFTER AFTER INTERVENTIONINTERVENTION
Simos et al, 2005
REMEDIATION STUDY
2 TREATMENTS – BOTH EXPLICIT PHONICS RX A “BOTTOM UP” (LiPS) VS A “TOP DOWN” (EP)
SEVERE DYSLEXIA 2nd %ILE FOR WORD READING 35th %ILE IQ
EQUAL TIME AND INTENSITY 1:1 100 MINS DAILY 8-9 WEEKS TOTAL 67.5 HRS
Torgesen et al, 2001, NICHD
OLDER CHILDREN (8 – 10 YRS)
RESEARCH DEMONSTRATES BOTH IMMEDIATE & LONG LASTING RESULTS IN BROAD
READING (DECODING+COMPREHENSION)S
tan
dar
d S
core
75
80
85
90
95
InitialTest
Pre-Treatment
Test
Post-Treatment
Test
1 YearAfter
Treatment
2 years
Normal Range of Performance
9-WeekIntensiveProgram
Torgesen, Alexander, Wagner et al, 2001
16 Mos.
Special Ed Class
81*
9193
TWO YEAR FOLLOW UP
READING RESULTS
WRMT-R
70
80
100
STA
ND
AR
D
SC
OR
E
90
WORD ATTACK
WORD ID PASSAGE COMP.
6968
82
30th percentile
N = 50
*
* p= <.05
*
Torgesen, Alexander, Wagner et al, 2001
72
96
*91
*
91
*
TWO YEAR FOLLOW UP
READING RESULTS
GORT-R
70
80
100
STA
ND
AR
D
SC
OR
E
90
WORD ATTACKWRMT-R
TEXT READING
ACCURACY
READING COMP.
TEXT READING
RATE
68
74
83
71
30th percentile
Torgesen, Alexander, Wagner et al, 2001
* p= <.05N = 50
SPOKEN LANGUAGE GAINS
GROWTH IN SPOKEN LANGUAGE DURING INTERVENTION &FOLLOW-UP
60
70
80
100
Pretest Post Test 1 year 2 years
Sta
nd
ard
Score
90
LIPS
CELF-R-RLS
CELF-R-ELS
EP
CELF-R-RLS
CELF-R-ELS
Torgesen, Alexander, Wagner et al, 2001
EFFECT SIZE OF TREATMENT ON LANGUAGE COMPREHENSION
LIPS EPPRE - POST PRE - 2 YRS PRE - 2 YRSPRE - POST
RLS
OD
WC
SR
LP
ELS
FS
RC
SA
1.05
0.75
0.61
0.61
0.62
0.85
0.60
0.24
0.75
0.97
0.75
0.44
0.93
0.58
0.71
0.70
0.54
0.49
0.49
0.31
0.50
0.37
0.03
0.70
0.44
0.20
0.76
1.05
0.46
0.84
0.43
0.38
0.67
0.60
0.16
0.78
P<= 0.05ES of 5 – 7 moderate; 8+ large
Decreased activity Decreased activity in right hemispherein right hemisphere Increased activity in Increased activity in
left hemisphereleft hemisphere
TREATMENTS EFFECTS ON BRAIN ACTIVITY
Simos et al 2002
EXCITING RESULTS!
HOWEVER……..
LATE VS EARLY INTERVENTION (PREVENTION)
WORD READING ACCURACY AND RATE
2nd 10th 10th 10th
70
80
90
100S
TA
ND
AR
D S
CO
RE
Accuracy
Rate
4th grade
2nd grade
30th % ile
BEGINNING % ile
TREATMENT AGE 8-11 5-6 5-68-11
PROJECTED GROWTH IN “SIGHT VOCABULARY” OF NORMAL READERS AND DISABLED CHILDREN
BEFORE AND AFTER REMEDIATION
Normal
InterventionSiz
e o
f “s
igh
t voca
bu
lary
Grade in School
1 2 3 4 5 6 7
Dyslexic
2nd Year follow-up
Later intervention does not close fluency gap – early intervention does
Torgesen
Torgesen, www.fcrr.org
EARLY INTERVENTION IS URGENT!
50TH %ILE 5TH GRADE READER 600,000 WORDS A YEAR
AVERAGE STUDENTS RECEIVE ABOUT 10 TIMES AS MUCH PRACTICE IN A YEAR
(Anderson, Wilson, & Fielding, 1988)
10TH %ILE 5TH GRADE READER 50,000 WORDS A YEAR
RESPONSE TO INTERVENTION MODEL
APPLICATION OF EVIDENCE-BASED TREATMENT TO SCHOOLS
TIER 1: CLASSROOM
TIER 2: PULL OUT SUPPORT
TIER 3 :TOTAL PULL OUT
A TIERED APPROACH
TIER TWOLITCHFIELD SCHOOL DISTRICT
PHOENIX, ARIZONA
ID BY CLASSROOM TEACHER SPALDING INSTRUCTION IN CLASSROOM READING / PA ASSESSMENT BELOW GRADE LEVEL OR, AT GRADE LEVEL, BUT STRUGGLING
NOT QUALIFIED FOR SLD
EXPLICIT, MULTISENSORY PROGRAM (LiPS) 40 MINS DAILY, 120 DAYS, 80-100 HRS GROUPS : 6-8:1 (YOUNGER) 8-12:1 (OLDER)
LSD RESULTS 1st GRADE
101
113
96
70
80
100
STA
ND
AR
D
SC
OR
E
90
WORD ATTACK
WORD ID PASSAGE COMP.
83
72
85
30th percentile
N = 63
*
* p= <.05
110
**
101108
98
LSD RESULTS 2nd GRADE
70
80
100
STA
ND
AR
D
SC
OR
E
90
WORD ATTACK
WORD ID PASSAGE COMP.
96
9395 30th percentile
N = 64
* *
* p= <.05
110
101100
96
LSD RESULTS 3rd – 5th GRADES
70
80
100
STA
ND
AR
D
SC
OR
E
90
WORD ATTACK
WORD ID PASSAGE COMP.
9191
95 30th percentile
N = 126
* **
* p= <.05
PRINCIPLES OF LEARNING WHAT FIRES TOGETHER, WIRES TOGETHER
– MULTIPLE SENSES STRENGTHEN PATHWAYS
OPTIMAL ATTENTION
CONSISTENT INPUT
INTENSITYSALIENTFREQUENT REPETITION, REPETITION, REPETITION
Alexander, 2003
TIER THREE
EINSTEIN MONTESSORI CHARTER
SCHOOL
FLORIDA
www.einsteinmontessori.com
EINSTEIN MONTESSORI SCHOOL, INC (EMS)
CHARTER SCHOOL (1999) REMEDIATE LITERACY SKILLS
LANGUAGE-BASED LEARNING DIFFICULTIES
2ND - 8TH GRADE LITERACY SKILLS FOUR CLASS PERIODS/DAY
1. PHONOLOGICAL AWARENESS (LIPS)
2. READING
3. READING
4. WRITING
TEACHER TRAINING ACROSS ALL CLASSES
EMS GAINS 2004-2005 (GRADES 3-5)
SIGNIFICANT IMPROVEMENT (P <0.001)WORD ATTACK PASSAGE COMPREHENSION PHONOLOGICAL PROCESSINGWORD & NONWORD READING EFFICIENCYSTATE ACHIEVEMENT TESTING
NON-SIGNIFICANT IMPROVEMENTWORD IDENTIFICATION
EINTSTEIN MONTESSORI RESULTS
HOWEVER….MANY MEASURES, WHILE SIGNIFICANT,DID NOT REACH 30TH%ILE BENCHMARK
THEREFORE….INSTITUTING AN INTENSIVE FOUNDATIONAL INTERVENTION
(LiPS) 3 HOURS/DAY X 6 WEEKS SMALL GROUP
0
50
100
150
200
250
300
350
4th 5th 6th 7th 8thGRADE
DE
VE
LO
PM
EN
TA
L S
CA
LE
SC
OR
E
FLORIDA STATEAVERAGE
ALACHUA COUNTYAVERAGE
EINSTEIN MONTESSORI
FCAT 2005
AVERAGE CHANGE IN READING DEVELOPMENT(IMPROVEMENT FROM 2004 TO 2005)
“TIER FOUR” 1:1
FOR THE TREATMENT RESISTERS
THE RESEARCH MODEL
THOROUGH BRAIN TEAM ASSESSMENT
TREAT OTHER FACTORS THAT MAY BE OBSTACLES ATTENTION BEHAVIOR SENSORIMOTOR
81*
9193
RESEARCH RESULTS 3rd – 5th GRADES
70
80
100
STA
ND
AR
D
SC
OR
E
90
WORD ATTACK
WORD ID PASSAGE COMP.
6968
82
30th percentile
N = 50
*
* p= <.05
*
CONCLUSION
TREATMENT IS MOST EFFECTIVE IF:YOUNGER AGE INTENSIVEEXPLICIT PHONOLOGICAL/PHONICSATTENTION IS OPTIMAL
“BOTTOM-UP” MORE EXPLICIT PHONICS APPROACH: PREVENTION
MILD TO SEVERE DYSLEXIA AUDITORY WORKING MEMORY WEAKNESS
“TOP-DOWN” PHONICS APPROACH:AFTER 3RD GRADE
MILD TO MODERATE DYSLEXIA
NEUROBIOLOGY REVIEW WHY DOES INTERVENTION WORK?
WHY“OUT OF LINE NEURONS” ( ECTOPIAS )
FRONT
http://www.thebrain.mcgill.ca/flash/d/d_02/d_02_cl/d_02_cl_vis/d_02_cl_vis.html#3
LAYERS OFBRAIN CORTEX
NEURALMIGRATION
http://www.thebrain.mcgill.ca/flash/a/a_09/a_09_cl/a_09_cl_dev/a_09_cl_dev.htm
GENETICALLY PROGRAMMED
NEURAL MIGRATION
GONE AWRY IN DEVELOPMENTAL DYSLEXIA
http://www.thebrain.mcgill.ca/flash/a/a_09/a_09_cl/a_09_cl_dev/a_09_cl_dev.htm
X
ECTOPIC CELLS
Ramus, 2004Ramus, 2004
NEURONAL CONNECTIONS
“OUT OF LINE NEURONS” ( ECTOPIAS )
FRONT
TYPICAL LANGUAGE ACTIVATION AREAS
SPEECHPRODUCTIONAREA
AUDITORYPROCESSINGAREA
VISUAL-LANGUAGEASSOCIATION AREA
VISUAL /VERBALAREA
LEFT HEMISPHERE
TYPICAL READING ACTIVATION AREAS
LEFT HEMISPHERE
WORD ANALYSISWORD ANALYSIS
AUTOMATIC(SIGHT WORD)
Strong activation Strong activation patternpattern
Weak activation Weak activation patternpattern
BRAIN ACTIVATION WITH READING
“SIGNATURE” BRAIN, Shaywitz, 2005
Simos, Fletcher, Bergman, et al 2002
BACKOF LEFTBRAIN
BACK
OF
RIGHT
BRAIN
PRINCIPLES OF LEARNING WHAT FIRES TOGETHER, WIRES TOGETHER
– MULTIPLE SENSES STRENGTHEN PATHWAYS
OPTIMAL ATTENTION
CONSISTENT INPUT
INTENSITYSALIENTFREQUENT REPETITION, REPETITION, REPETITION
Alexander, 2003
WHAT HAVE WE LEARNED FROM RESEARCH?
GOOD SCIENCE BEHIND INSTRUCTION AND MATERIALS.INFORMED CONSUMERS OF
MATERIALS. FOLLOW PRINCIPLES OF LEARNING. PREVENTION IS THE MOST EFFECTIVE
TREATMENT APPROACH.
FUTURE DIRECTIONS SHOULD WE ACCEPT THE PERSISTENCE OF
A “GAP” AND ONLY FOCUS ON THE STRENGTHS?HAVE WE LEARNED ALL THERE IS TO KNOW
ABOUT IMPROVING LANGUAGE AND LEARNING SKILLS?
IS “CLOSING THE GAP” AN ACHIEVABLE GOAL? PREVENTION RESEARCH CLOSED THE GAP IN
FLUENCY AND READING ACCURACY. REMEDIATION RESEARCH CLOSED THE GAP IN
READING ACCURACY AND IMPROVED FLUENCY.
NCLB – THE LEGISLATURE’S RESPONSIBILITY.
NCLB – OUR RESPONSIBILITY IS TO PREVENT AND REMEDIATE LANGUAGE/LEARNING DISABILITIES; GIVIVING THE TAX PAYER THEIR MONEY’S WORTH.
AVAILABLE SCIENCE
JOE TORGESEN, Ph.D. WWW.FCRR.ORG
RICHARD WAGNER, Ph.D. NICHD – FSU LEARNING DISABILITIES RESEARCH CENTERGENETICS / DYSLEXIA
REGISTRYFOLLOW SEVERE
DYSLEXICSWEBSITE – CLEARING
HOUSE FOR TREATMENT RESEARCH
Acknowledgments
National Institute of Child Health and Human Development
Joe Torgesen Carol Rashotte Rick Wagner Pat Lindamood Jane Lawyer Sally Shaywitz
THANK YOU
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